The impact of a high-quality basic life support police-based first responder system on outcome after out-of-hospital cardiac arrest.

Autor: Krammel M; Department of Anesthesiology, Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria.; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria.; Emergency Medical Service, Vienna, Austria., Lobmeyr E; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria.; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria., Sulzgruber P; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria.; Division of Cardiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria., Winnisch M; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria.; Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria., Weidenauer D; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria.; Division of Cardiology, Department of Medicine II, Medical University of Vienna, Vienna, Austria., Poppe M; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria., Datler P; Department of Anesthesiology, Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria., Zeiner S; Department of Anesthesiology, Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria., Keferboeck M; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria., Eichelter J; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria.; Emergency Medical Service, Vienna, Austria., Hamp T; Department of Anesthesiology, Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria.; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria., Uray T; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria., Schnaubelt S; PULS-Austrian Cardiac Arrest Awareness Association, Vienna, Austria.; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria., Nuernberger A; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Jun 02; Vol. 15 (6), pp. e0233966. Date of Electronic Publication: 2020 Jun 02 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0233966
Abstrakt: Background: Laypersons' efforts to initiate basic life support (BLS) in witnessed Out-of-Hospital Cardiac Arrest (OHCA) remain comparably low within western society. Therefore, in order to shorten no-flow times in cardiac arrest, several police-based first responder systems equipped with automated external defibrillators (Pol-AED) were established in urban areas, which subsequently allow early BLS and AED administration by police officers. However, data on the quality of BLS and AED use in such a system and its impact on patient outcome remain scarce and inconclusive.
Methods: A total of 85 Pol-AED cases were randomly assigned to a gender, age and first rhythm matched non-Pol-AED control group (n = 170) in a 1:2 ratio. Data on quality of BLS were extracted via trans-thoracic impedance tracings of used AED devices.
Results: Comparing Pol-AED cases and the control group, we observed a similar compression rate per minute (p = 0.677) and compression ratio (p = 0.651), mirroring an overall high quality of BLS administered by police officers. Time to the first shock was significantly shorter in Pol-AED cases (6 minutes [IQR: 2-10] vs. 12 minutes [IQR: 8-17]; p<0.001). While Pol-AED was not associated with increased sustained return of spontaneous circulation (p = 0.564), a strong and independent impact on survival until hospital discharge (adj. OR: 1.85 [95%CI: 1.06-3.23; p = 0.030]) and a borderline significance for the association with favorable neurological outcome (adj. OR: 1.58 [95%CI: 0.96-2.89; p = 0.052) were observed.
Conclusion: We were able to demonstrate an early start and a high quality of BLS and AED use in Pol-AED assessed OHCA cases. Moreover, the presence of Pol-AED care was associated with better patient survival and borderline significance for favorable neurological outcome.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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